tbuckley/cabot-search huggingface dataset:
Abstract P141: Six-Month Follow-Up of <i>Menopausia, Salud, Corazón</i> (Menopause, Health, Heart): A Multi-Component Intervention to Reduce Cardiovascular Disease Risk in Midlife Latinas
Authors: Yamnia I Cortes, Mayra Duran, Andrea Cazales, Latesha K. K Harris, Valentina Marginean, Jamie Crandell, Lee Stoner, Cheryl Giscombe, Krista Perreira
Journal: Circulation (2023)

Background: Cardiovascular disease (CVD) risk increases substantially during perimenopause. Latinas have a significantly worse CVD risk factor profile than non-Latina White women, potentially due to multiple sociocultural and environmental factors. The purpose of this study is to evaluate the feasibility and initial efficacy of a multi-component intervention to reduce CVD risk in perimenopausal Latinas. Here we report data at a 6-month follow-up. Methods: This is a randomized two-group, repeated measures experimental study. Forty-nine perimenopausal Latinas (age 40-60 years) were randomized to a 6-month multi-component intervention or wait-list control. The intervention consists of 12-weekly culturally tailored Spanish language-based sessions (education, physical activity, stress management, coping skills training), followed by 3 months of continued support, and 6 months of skill maintenance on their own. Between May 2021 and June 2022, thirty-five participants (18 intervention and 17 control) completed a 6-month follow-up. Primary outcomes at this study visit included weight, body mass index, waist circumference, and blood pressure. Secondary outcomes included health behaviors and psychological factors (nutrition, physical activity, sleep, self-efficacy, perceived stress). We assessed the initial efficacy of the intervention at 6 months using general linear models for continuous outcomes and logistic regression for categorical outcomes. Models adjusted for outcome measures at baseline and baseline group differences (health insurance, vasomotor symptoms). Models were two-sided at a level of significance of p≤0.1. Results: At baseline, the mean age was 47.8 ± 4.4 years, 37% had less than high school education, 97% were born outside of the United States, and 51% reported it was somewhat/very difficult to pay for basics. Women in the intervention group were more likely to have health insurance (61% vs 24%, p=0.06) and less likely to report any vasomotor symptoms (44% vs 77%, p=0.09). At 6 months (post-intervention), compared to the waitlist control group, the intervention group had lower perceived stress (ß[SE]= -2.15 [1.05], p=0.05) and systolic blood pressure (ß[SE]= -2.72 [1.61], p=0.1) even after adjusting for baseline measures and group differences. There were no other significant differences post-intervention. Conclusions: This pilot study found that a culturally tailored Spanish language intervention consisting of nutrition education, physical activity, and stress management may be effective in reducing stress and blood pressure in perimenopausal Latinas —key risk factors for CVD.
Abstract P439: Ideal Physical Activity is Associated With Reduced Risk of Atrial Fibrillation in African Americans Without Baseline Cardiovascular Disease: The Jackson Heart Study
Authors: Jack Tiahnybik, Marielle Siebert, Daisuke Kamimura, Wondwosen Yimer, Yuan-I Min, Kaustuv Bhattacharya, James S Floyd, Yi Yang, Susan R Heckbert, Michael E Hall, Adolfo Correa, Takeki Suzuki
Journal: Circulation (2023)

Background: The effect of physical activity (PA) on incidence of atrial fibrillation (AF) is unclear in African Americans (AA). This study aimed to determine if higher levels of PA are associated with decreased incidence of AF in the Jackson Heart Study (JHS). Methods: Participants of the JHS with PA assessment and without previous AF at baseline were included in the study. PA was categorized based on the American Heart Association physical activity levels. Incident AF was defined as having 12 lead electrocardiogram evidence at a subsequent follow up, or a documented diagnosis code at the time of hospital discharge from 2000 to 2016. Cox proportional hazards models were used to evaluate for the association between baseline PA and incidence of AF. Given significant correlation between PA and baseline cardiovascular disease (CVD), stratified analysis was performed based on CVD status. Results: Of the 4,477 participants followed for a median of 12.5 years, 398 developed AF (7.13 cases per 1,000 person-years). Ideal and intermediate PA were associated with a reduced risk of incident AF compared with poor PA (unadjusted HRs with 95% CIs 0.47 [0.34 - 0.64] and 0.72 [0.58 - 0.90], respectively) (Table). After adjustment for traditional cardiovascular risk factors, the associations attenuated and became no longer significant (0.73 [0.53 - 1.00] and 1.00 [0.80 - 1.25], respectively). In stratified analysis based on baseline CVD status, in participants without baseline CVD, ideal PA was significantly associated with a reduced risk of AF while intermediate PA was not (0.68 [0.47 - 0.98] and 1.00 [0.78-1.29], respectively). In participants with baseline CVD, ideal PA or intermediate PA was not associated with incident AF. Conclusion: Ideal PA was associated with a reduced risk of AF in participants without baseline CVD in this AA community cohort. Our findings show intertwined relationship among PA, CVD, and incident AF. Physical activity could be a possible therapeutic target to reduce AF incidence in the AA general population without CVD.
Abstract P429: Adiposity: Full or Partial Mediator of the Association of Diet With Blood Pressure?
Authors: Amaris Williams, Joshua J Joseph
Journal: Circulation (2023)

Background: Recently published results suggest body mass index (BMI) fully mediates the association of Dietary Approaches to Stop Hypertension (DASH) diet score with hypertension in women from the United Kingdom. The DASH diet has been shown to reduce systolic and diastolic blood pressure (SBP &amp; DBP) while keeping BMI constant in United-States-(US)-based trials. Thus, we quantified the mediation of adiposity in the association of DASH diet with SBP and DBP in a US nationally representative sample. Methods: Using National Health and Nutrition Examination Survey (NHANES) data, years 2011-2018, the association of DASH score (scale: 8 - 40) with SBP and DBP was quantified with and without BMI or waist circumference (WC) in models adjusted for age, sex, education, income, and physical activity. Percent mediation was calculated from all sets of models. Results: The included sample (n=11,662) was aged 20 years or older (median 41 years), was not taking blood pressure medication, and was weighted to be representative of the US population. For SBP, in models without BMI or WC, a one-point higher DASH score was associated with a -0.21 mmHg lower SBP in the adjusted base model (p &lt; 0.001). With the addition of BMI to the adjusted base model, the effect estimate was -0.12 mmHg (p = 0.005) for DASH score. With the addition of WC to the base model, the effect estimate was -0.13 mmHg (p=0.006) for DASH score. Thus, BMI and WC mediated 34% and 41% of the association between DASH and SBP in adjusted models, respectively. For DBP, in models without BMI or WC, a one-point higher DASH score was associated with a -0.15 mmHg lower DBP in the adjusted model (p &lt; 0.001). With the addition of BMI to the base model, the effect estimate was -0.10 mmHg (p = 0.004). With the addition of WC to the base model, the effect estimate was -0.11 mmHg (p = 0.003) for DASH score. Thus, BMI and WC mediated 29% and 52% of the association between DASH and DBP in adjusted models, respectively. Conclusion: Adiposity is a partial mediator of the association of DASH score with SBP and DBP. The mechanisms that explain the greater mediation of WC than BMI in the association of DASH score with SBP and DBP require further elucidation. The effect of the DASH diet on blood pressure may have multiple mechanistic pathways: one that works through adiposity and others that work through non-adiposity-based mechanisms including higher potassium consumption and lower sodium consumption.
Abstract P446: Physical Inactivity and Chronic Conditions Are Associated With Lower Functioning in Older Adults With Osteoarthritis
Authors: GRAZIELLA MARTINS DE DE MELLO, Ariele Barreto Haagsma, Fernando T Frajácomo, Dyego Leandro Bezerra de Souza, Vanessa Barbosa de Oliveira, Ana Paula Vieira Neves Ferreira, Javier Jerez-Roig, Cristina P Baena
Journal: Circulation (2023)

Introduction: Population aged &gt;60 years compose the age group that grows the most disproportionately. Despite several positive individual and social aspects an increase in the prevalence of chronic non-communicable diseases, including OA is observed. Hypothesis: Whether physical activity (PA) levels and number of chronic diseases are associated with handgrip strength (HGS), chair stand test (CST) results, and difficulties to dressing among older adults presenting with hip pain and diagnosed with hip osteoarthritis (OA). Methods: We analyzed Wave 5 of the Survey of Health, Ageing and Retirement in Europe. We analyzed two age groups of individuals diagnosed with hip OA: 60-79 and 80-100 year groups. Univariate and multivariate logistic models were constructed considering the poor performance cut-offs in the strength, functioning, and mobility tests as the dependent variables, and physical inactivity, number of chronic diseases, body mass index (BMI), gender and education as the exposure variables. Results: We included 2.088 participants (mean age 73.1±8.5 years). The majority (89.3%) reportedly had two or more chronic diseases, the most prevalent being hypertension. The participants were mostly overweight or obese (69.8%); however, two of three (75%) participants reported moderate-to-vigorous daily activity. Low levels of moderate-to-vigorous PA were significantly and independently associated with muscle weakness, dysfunctioning, and poor mobility in both age groups (p&lt;0.05). Having five or more chronic diseases was significantly associated with disability in individuals with hip OA aged ≥60 years (p&lt;0.05). Conclusions: Low PA levels and chronic conditions are significantly associated with reduced functioning in individuals aged ≥60 years with symptomatic hip OA, especially in the 80-100 year subgroup. These findings are important for stakeholders to maintain adequate PA levels in older individuals despite their hip OA diagnoses.
Abstract P199: Proteomic Markers of Aortic Stenosis: The Atherosclerosis Risk in Communities Study
Authors: Khaled Shelbaya, Victoria Arthur, Leo Buckley, Brian Claggett, Hicham Skali, Christie M Ballantyne, Josef Coresh, Kuni Matsushita, Bing Yu, Amil M Shah
Journal: Circulation (2023)

Introduction: Although prevalence of aortic stenosis (AS) is increasing, little is known regarding circulating proteins predictive of AS development. Hypothesis: Novel circulating proteins associated with AS hemodynamics and clinical outcomes can be discovered using plasma proteomics. Methods: In the community-based Atherosclerosis Risk in Communities study, we measured plasma proteomics using the SOMAscan aptamer-affinity assay (n=4,877 aptamers; Somalogic Inc.) at study Visits 3 (V3; 1992-94; n=11,430) and 5 (V5; 2011-2013; n=4,899). Multivariable linear regression was used to estimate cross-sectional associations of log-transformed proteins at V5 with aortic valve (AV) peak velocity (Vmax) assessed by protocol echocardiography at a false discovery rate (FDR) of &lt;0.05. We then assessed the association of Vmax-related proteins at V3 with incident AV-related hospitalizations post-V3 using multivariable Cox proportional hazard models at FDR of &lt;0.05. All models adjusted for cardiovascular risk factors and diseases at the time of visit. Results: At V5 (age 76 ± 5 years; 43% male; 18% Black adults), 946 proteins were cross-sectionally associated with Vmax. At V3, (age 60 ± 6 years; 46% male; 21% Black), 84 of these were associated with risk of AS-related hospitalization post-V3 (median follow-up 22.2 [IQR 14.4 - 24.8] years, n=912 events). Of these 84 proteins, 52 were also cross-sectionally associated with the Dimensionless index (DI) at V5. Hierarchical clustering based on V5 AV hemodynamic indices identified one cluster of 14 proteins associated with lower hemodynamic AS severity and risk of AV-related hospitalization ( Figure ). Proteins in the remaining three clusters were associated with higher Vmax, lower DI, and higher risk of AV-related hospitalization. The nine proteins in cluster 4 were also associated with lower indexed AV area. Conclusion: We identified 52 circulating proteins with robust associations with AV hemodynamics and hospitalization risk, providing potential novel biomarkers for AS risk.
Abstract P450: The Moli-Sani Risk Score, a New Algorithm for Measuring the Global Impact of Nine Modifiable Cardiovascular Risk Factors
Authors: Augusto Di Castelnuovo, Marialaura Bonaccio, Simona Costanzo, Amalia De Curtis, Mariarosaria Persichillo, Teresa Panzera, Damiano Baldassarre, Maria Carla Roncaglioni, Marta Baviera, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello
Journal: Circulation (2023)

Introduction: Cardiovascular (CV) disease, the leading cause of death globally, is largely preventable through targeting modifiable risk factors. Scores of modifiable CV risk factors able to collect the combined effect of all the included components were mainly developed in US populations, or do not include nutritional aspects. Hypothesis: We assessed the hypothesis that an algorithm for measuring the global impact of nine modifiable CV risk factors, including dietary factors is useful in a Mediterranean population. Methods: Data on 16 656 participants of the Moli-sani Study (age ≥45y, 47% men), Italy, were used. The Moli-sani Risk Score (MRS) was calculated as a weighted sum of smoking, adherence to Mediterranean diet, LDL and HDL cholesterol, triglycerides, blood pressure, glucose, physical activity and relative fat mass. A composite outcome of fatal or non-fatal CV events was used. The Risk-and-Prevention Study, Italy (N=8606) acted as external validation cohort and the Life's Simple 7 metric as benchmark. Results: In the derivation cohort, 816 CV events occurred in 8.1 years (median) of follow-up. In multivariable Cox analysis adjusted for non-modifiable risk factors, 1-unit increase in the MRS was associated with a hazard ratio (HR) for CV events of 1.07 (95%CI: 1.06-1.08). In comparison with individuals in the first quartile, those in the fourth quartile of the MRS had HR=3.18 (2.54-3.97, Table). In the validation cohort, individuals in the fourth quartile reported a HR=1.69 (1.39-2.05). In comparison with the Life's Simple 7 metric, the MRS performed better in the derivation cohort and similarly in the validation cohort. Conclusions: The Moli-sani Risk Score is a validated, replicable algorithm predictive of CV events, based on nine modifiable CV risk factors, well performing in a Mediterranean population. The MRS can be useful to evaluate the efficacy of preventive strategies, to design intervention schemes and to communicate effectiveness of a preventive action, increasing compliance to the strategy itself.
Abstract P111: Facilitators and Barriers to Physical Activity Among African American Long-Term Breast Cancer Survivors
Authors: Yvonne R Ford, Bobbi Brown
Journal: Circulation (2023)

Introduction: Breast cancer survivorship guidelines from the American Cancer Society (ACS) and American Society of Clinical Oncologists (ASCO) contain recommendations for health promotion, specifically obesity, nutrition, and physical activity. Breast cancer treatment is often cardiotoxic because of anthracycline- based drugs, radiation therapy, and use of monoclonal antibodies. Many African American (AA) BCS have preexisting conditions such as hypertension, obesity, and diabetes when diagnosed with breast cancer. Evidence suggests that breast cancer survivors (BCS) with sedentary lifestyles, obesity, and lack of physical activity have poorer outcomes among survivors. Research indicates AA BCS are less likely to be encouraged to lose weight or participate in physical activity by healthcare providers. Hypotheses: 1) Physical inactivity, smoking, and suboptimal dietary patterns adversely affect cardiovascular health and survival of AA female BCS; and 2) Socioeconomic, cultural, and environmental factors serve as barriers or facilitators to adopting heart healthy behaviors and health outcomes. Methods: The sample consisted of 14 participants in three focus groups. Because these women had been discharged from acute oncology care, they were recruited from the AA community in Greensboro and Durham, NC. The organizations included cancer survivor organizations, religious and community organizations, and by referral from participants. Focus groups were held in locations that provided privacy for participants to verbally express themselves and interact with others freely. Anthropometric and biomarker data were collected from each participant and are reported elsewhere. Results: Using thematic analysis, verbatim transcripts were analyzed using word processing software. We familiarized ourselves with the focus group data, and continued with coding, theme generation, review and naming. The overarching themes identified were eating habits, thoughts about exercise, thoughts about weight, physician advice, and the importance of regular exercise. Conclusions: In conclusion, because many BCS are at risk for late and long-term cardiac effects of cancer treatment therapies, it is advisable to promote cardiovascular health behaviors that connect other health recommendations as suggested by the American Heart Association’s Life’s Simple 7. Accordingly, it is necessary to assess socioeconomic, cultural, and environmental factors that may influence heart healthy behaviors and health outcomes before creating culturally relevant interventions.
Abstract MP44: Cardiovascular and Behavioral Correlates of Restless Leg Syndrome in the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Mercedes R Carnethon, Mandy Wong, Shaina Alexandria, Sabra Abbott, Diana Chirinos, S. Justin Thomas, Cora E Lewis, Elizabeth C Feliciano, Stephen Sidney, Pamela J Schreiner, Kristen Knutson
Journal: Circulation (2023)

Background: Restless Legs Syndrome (RLS) is a neurological condition characterized by uncomfortable sensations in the legs at rest that leads to sleep disruption and impaired quality of life. Correlates of RLS in prior studies are inconsistent but include many correlates of cardiovascular disease (CVD) risk factors. The objective of our study is to describe the burden and correlates of RLS in an epidemiological study of middle-aged adults. Methods: Participants in the CARDIA study completed the Cambridge-Hopkins RLS questionnaire between 2020-2022. Sociodemographic characteristics, cigarette smoking, physical activity, alcohol intake, depressive symptoms, parity and menopausal status were determined based on self-report. Waist circumference, body mass index (BMI) and blood pressure were measured using standard procedures. Serum glucose and creatinine were measured in fasting samples. A spot urine collection was used to determine urinary albumin and creatinine. Hypertension and diabetes were determined based on current clinical guidelines. We carried out univariate and multivariable logistic regression modeling to identify correlates associated with RLS. Results: In 2337 CARDA participants (44% Black and 60% female) with a mean age of 55.2 years old (SD=3.6), 120 (5.5%) participants (white women=78, black women=12, white men=26 and black men=4) endorsed symptoms of RLS. White participants and females were significantly more likely to endorse having RLS (Table). Health behaviors assessed in our study were not associated with RLS; however, the presence of diabetes and markers of adverse kidney function (i.e., serum creatinine, ACR) were associated with a higher odds of RLS and these associations persisted in a multivariable model. Conclusion: Metabolic disorders that lead to microvascular and peripheral nerve damage were associated with RLS in this sample. Future research should investigate whether RLS and peripheral neuropathy are overlapping conditions.
Abstract MP39: Associations of Disordered Eating and Weight Control Behavior With Cardiovascular Health Score: The Coronary Artery Risk Development in Young Adults Study
Authors: Brittanny Polanka, Cynthia Yoon, David R Jacobs, Pamela Schreiner, Nancy Sherwood
Journal: Circulation (2023)

Introduction: Psychological and behavioral factors negatively impact cardiovascular health (CVH), defined by Life’s Simple 7. Few studies have investigated disordered eating and weight control behaviors and CVH, particularly outside of adolescence. Objective: To examine the cross-sectional and longitudinal associations of disordered eating and weight control behaviors with CVH among middle-aged adults. Methods: We studied CARDIA participants assessed between Y10 (1995-1996) and Y30 (2015-2016) excluding pregnant/breastfeeding individuals at Y10. The Questionnaire on Eating and Weight Patterns-Revised (QEWP-R) was administered at Y10 and used to create the Problematic Relationship to Eating and Food (PREF) score, an aggregate measure (range 0-8) of eight disordered eating and weight-related behaviors (anxiety surrounding food, compensatory behaviors, overeating, loss of control, distress surrounding overeating, distress surrounding loss of control, shape concerns, time spent dieting). Diet, physical activity, smoking, blood pressure, cholesterol, glucose, and body mass index (BMI) were measured at Y10 and Y30 (except diet at Y7 and Y20) and used to define CVH categories Low-to-Moderate (0-9) or High (10-14). Logistic regression analyses were used to evaluate associations between PREF score and CVH category. Results: We included 2,040 participants (mean age 35.2 years, 55% female, 43% Black). At Y10, every 1-unit increment in PREF was associated with 19% higher odds of Low-to-Moderate vs. High CVH in adjusted models ( Table ). At Y30 after 20 years of follow-up (mean age 55.3 years), every 1-unit increment in PREF at Y10 was associated with 11% higher odds of Low-to-Moderate vs. High CVH at Y30 in adjusted models ( Table ). Further adjustment for Y10 BMI attenuated the relationship (OR=0.93, 95%CI: 0.87-0.99). Conclusion: Higher levels of problematic behaviors and attitudes towards eating are associated with less optimal CVH throughout middle-age, likely through weight increases.